Acupuncture – good vs bad OR good vs sham?

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Attending the acupuncture conference this weekend this was an issue that came up time and time again as it is such an issue in acupuncture research. One of my more cynical patients told me he found acupuncture difficult to rationalise because of this, even though it worked for him and he comes in for treatment whenever he has a running injury.
Looking at the research and what the lecturers had to say, what comes up consistently is that when compared to a gold standard conventional treatment for many conditions, acupuncture is significantly more effective. However, for the current models of research, the treatment tested needs to be significantly better compared to a placebo which in this case would be ‘sham’ acupuncture . This poses a real problem in acupuncture research – if you look at the different theories proposed for the mechanisms involved in acupuncture analgesia, you cannot get past the fact that even sham acupuncture is nevertheless also triggering the same mechanisms – although maybe not quite as effectively. However, what must not be overlooked is that even the ‘sham’ acupuncture, or really, poor quality acupuncture, was also still significantly better than the gold standard for certain conditions. This poses another difficulty for the pharmaceutical industry as even the so called ‘placebo’ acupuncture was significantly more effective than some of their drugs.
So what can we conclude from this? Maybe that even bad acupuncture is better than none and certainly that acupuncture – good or bad- would be worthy of consideration when you’re looking for alternatives for your condition.

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